ABSTRACT Raheem Paxton, PhD is a behavioral scientist seeking to focus his career on cancer survivorship. In this no- cost extension period, we propose to finalize the remaining aims of our original application and expand our focus to include rural cancer survivors. The work proposed in our application complements our initial aims which were to (1) examine the correlates of physical activity in secondary data and (2) examine the feasibility and a lifestyle intervention in African American breast cancer survivors. Our work indicated that African American breast cancer survivors experienced significant barriers and comorbidities that prevented regular engagement in physical activity. However, they were receptive to participating in interventions; particularly, those delivered via email or the Web. Therefore, we recruited and randomized an ethnically diverse sample of breast cancer survivors to either a 3-month physical activity or dietary condition delivered via email. Preliminary data indicated that survivors were satisfied with A Lifestyle Intervention via Email (ALIVE) and would recommend it to other cancer survivors. In addition, we found that ALIVE was associated with significant improvements in physical activity, reductions in sedentary behavior, and positive trends in fruit and vegetable consumption, relative to the comparison condition. In the no-cost extension period, we propose to examine the real-time correlates of physical activity, dietary intake, and sedentary behavior in a sample of rural cancer survivors via experience sampling methods. Using this sampling method will provide a landscape for understanding the psychosocial and contextual factors that predict lifestyle behaviors in real time. Furthermore, accomplishing these goals will lay the groundwork for developing a behavioral intervention that occurs in real time. The mentoring, coursework and related skill development will enable me to accomplish my long-term goal of developing interventions for at-risk and underserved cancer survivors. Pending Submissions: Funding Mechanism: Earlier.org Title: Cumulative Risk and Metabolic Dysfunction in African American Women Abstract: Cumulative exposures to chemical (i.e., personal volatile organic compounds) and non-chemical stressors (i.e., diet, exercise, substance use, depression, and social determinants of health) place minority women at greater risk for developing metabolic abnormalities and aggressive cancer subtypes. Although studies have examined the individual impact that lifestyle, environmental exposure, and biological mediators have on cancer initiation, development, and metastasis, there is a paucity of literature documenting the cumulative risk associated with these factors. The primary aim of this study is to determine the association of a cumulative risk assessment score with salivary markers (e.g., estrogen, sex hormone binding globulin (SHBG), cancercinoembryonic antigen (CEA), epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF) related with metabolic abnormalities and cancer. Data will be collected from 120 postmenopausal African American women. Urine and saliva samples will be collected to examine environmental exposures and cancer-related markers. Cumulative risk score will be developed based on equations generated from Machine or Statistical Learning (e.g., Random Forest, Regularized Regression). Results of this study will serve as preliminary data for a larger award to collect primary data for understanding evidence-based relationships between chemical, non-chemical stressors, and metabolic markers associated with various metabolic disorders. Funding Mechanism: Cancer Prevention Research Institute of Texas Title: Disseminating A Lifestyle Intervention via Email (ALIVE) to Cancer Survivors Abstract: The proposal represents new collaborative partnerships between the University of North Texas Health Science Center (UNTHSC), The University of Texas MD Anderson Cancer Center (UTMDACC), Texas Health Resources (THR), JPS Center for Cancer Care (JPSCCC), Cook Children's Health Care System (CCHCS), and community-based organizations to disseminate a nutrition and PA survivorship care plan in the clinical setting and an evidenced-based person wellness coaching program entitled ?A Lifestyle Intervention via Email (ALIVE)? to cancer survivors throughout the state of Texas. ALIVE, a web- and email-based platform, has demonstrated efficacy in improving HRQoL as well as nutrition and PA behaviors. Our long-term goal is to improve HRQoL among cancer survivors by improving physical activity and dietary patterns. This proposal will achieve that goal by educating clinicians and community-based organizations on the ACS guidelines on Nutrition and PA, and disseminating ALIVE to cancer survivors in long-term follow-up clinics. In particular, our educational initiative will target survivorship practitioners in the clinical- and community-based settings. Moreover, we will aim to disseminate >10,000 nutrition and PA survivorship care plans and enroll 1500 cancer survivors of various diagnoses into ALIVE portal. The implementation, dissemination, and evaluation of the proposed study will be guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Framework. The collaborative team brings state-of-the-science experience in programming, vital community outreach, training knowledge, and program evaluation expertise together on this proposal to facilitate the dissemination of the ACS guidelines on nutrition and PA throughout various settings to continued monitoring and adaptations to assure its sustainability for the foreseeable future. Therefore, this proposal is highly significant for its potential dissemination throughout the state of Texas and its ability to make meaningful improvements in HRQoL via changes in lifestyle behaviors.